Background

Understanding the relevance of biological and social factors to sex differences in the prevalence and detection of depressive and anxiety disorders has been impaired by the lack of standardized research methods across cultures.

Method

Prevalence rates of depressive and anxiety disorders were assessed using a 2-stage design from 26 969 patients attending for primary care in 15 centers from 4 continents.

Logistic regression analysis was used to examine sex differences in prevalence and detection across centers.

Results

Odds ratios for women compared with men of current depression (1.60 ; 95% confidence interval [CI], 1.37-1.86) and agoraphobia or panic (1.63 ; 95% Cl, 1.18-2.20) were consistent across centers.

There was no sex difference in the detection of depressive and anxiety disorders by physicians across centers.

Conclusions

The absence of a sex-by-center effect for current depression and agoraphobia or panic disorder is consistent with biological and psychosocial factors, either interacting or working alone, that have a similar final effect across cultures.

It does not support the idea that sex differences in prevalence are caused by local psychosocial factors that vary from country to country. (...)